Posts Tagged ‘preemie’

Is breastfeeding a preemie different than a full term baby?

Friday, February 3rd, 2017

preemieThe answer is yes.

You’ve probably spent the last few months anxiously getting ready for your baby’s arrival. You’ve probably also thought about and decided how you are going to feed your baby after birth. Unfortunately, your breastfeeding plans may need to change in order to accommodate your baby, if you gave birth prematurely (before 37 weeks of pregnancy).

Breastfeeding in the NICU

If your baby is in the NICU, you may need to start pumping to establish your milk supply. Although you won’t have your warm baby at your breast, give your baby any expressed colostrum or milk you produce. Breast milk provides many health benefits for all newborns, but especially for premature or sick babies in the NICU.

Read our tips and tricks to breastfeeding your baby in the NICU.

Late preterm babies

If your baby was born late preterm, between 34 weeks and 0 days and 36 weeks and 6 days of pregnancy,  the good news is that she may not need to spend any time in the NICU. The bad news is that breastfeeding a near-term baby can be very difficult. Late preemies are often very sleepy and lack the energy they need to latch, suck and swallow. Also, late preterm babies are vulnerable to hypothermia (low body temperature), hypoglycemia (low blood sugar), weight loss, slow weight gain and jaundice among other conditions, which may interrupt your breastfeeding progress.

Full term babies

Breastfeeding a full term baby has its challenges, too. But, compared to a preterm or late preterm baby, there are more opportunities to be successful with breastfeeding from the start, due to fewer health obstacles.

Stay positive

If your baby is spending time in the NICU or having trouble breastfeeding, the breast milk you provide your baby through expression or pumping is very beneficial to his growth and protection from illness and infection. Seek help when you need it through a Lactation Consultant, a nurse or your health care provider. If you are in the hospital, ask your nurse if they have a support group where you can connect and share with other moms going through the same situation.

Learn more in Breastfeeding 101.

Have questions? Text or email us at AskUs@marchofdimes.org.

 

What if my baby needs surgery?

Friday, November 11th, 2016

mom-and-preemieThe idea of surgery is scary for anyone. But learning your premature baby needs to have surgery can be terrifying. Learning what you can expect may make things a little easier. The following information is adapted from Preemies: The Essential Guide for Parents of Premature Babies.

Ask a lot of questions

  • Talk to your baby’s neonatologist, the surgeon who will be operating, the anesthesiologist, and any other specialists who may be involved in your baby’s care.
  • Don’t be afraid to ask ANY questions that you have. It may be helpful to write them down as you think of them so that you don’t forget to ask when you see your baby’s doctors.  You may meet with someone unexpectedly and you will not want to miss the opportunity to get answers to your questions. Perhaps keep a notebook or pad in your handbag so you can jot down your thoughts as they cross your mind.
  • Also, take advantage of talking to the NICU nurses. They have cared for many preemies and understand your fears and concerns and can give you an idea of what is going to happen.

Surgery

  • Most premature babies are put under general anesthesia for surgery. This means that your baby will not be able to move during the surgery. She will not feel any pain or have any memory of the procedure.
  • If general anesthesia is used, your baby will not be able to breathe on her own and will need to be on a ventilator.
  • The surgical team will be monitoring your baby to make sure she is as comfortable as possible. During the surgery, your baby will be kept warm. The room temperature will be raised and she will be covered as much as possible. IV fluids may be warmed as well.

Recovery

  • Preemies need very special care after surgery. Immediately after surgery, your baby will remain in a recovery area while the anesthesia wears off.
  • The surgical team will then accompany your baby back to the NICU and update the neonatologists and bedside nurses.
  • It will take some time for the anesthesia to leave your baby’s body. This means she may be on a ventilator to help her breathe. If your baby didn’t have a breathing problem before surgery, she may be removed from the ventilator within hours or up to a few days after surgery. Babies who did have breathing problems will most likely need to be on a ventilator for a longer period of time.
  • Pain can delay healing and recovery, so your baby’s NICU team will be watching carefully for any signs that she is uncomfortable. The medication your baby receives to manage pain depends on a number of factors. Make sure you ask the doctors and nurses if you have concerns.

Asking questions and understanding what to expect before, during, and after your baby’s surgery, can help you feel more confident and better prepared for the procedure. You may also find it helpful to talk to other parents who have been through a similar experience with their preemie. Share Your Story, our online community, will allow you to connect with other moms and dads who can offer advice and support.

And, of course, we are here to answer any questions you may have. Send them to AskUs@marchofdimes.org.

 

 

 

 

How to establish your milk supply while your preemie is in the NICU

Monday, August 8th, 2016

kangaroo-care-23If your baby is in the NICU, you may not be able to breastfeed the way you imagined. But providing your preemie with your breast milk will give her the best start in life.

Here are some tips to help establish your milk supply:

Ask for support

Seek out the help of a Lactation Consultant. She is a person with special training to help women breastfeed. A Lactation Consultant will be the best person to assist you with your breastfeeding goals. Your partner, friends and family are also there to support you during this important time.

Pump or express your milk early

Your milk is designed to meet your baby’s needs, so even though your baby was born early, the milk you make in the early days has a higher amount of antibodies to help her fight off infection. If your preemie is too small, sick or has birth defects that prevent her from breastfeeding, pump or hand express your milk as soon as possible. Your Lactation Consultant will be able to help you find the pump that works best for you. Ask your consultant if the milk you pump can be given to your baby in the NICU.

Spend time with your baby

If your baby’s nurse says it is OK, practice skin-to-skin or kangaroo care with your preemie. Not only is this beneficial for your baby, but having her so close will help you make more breast milk. Pumping or expressing your milk right after holding your baby skin-to-skin, or just smelling your baby’s scent, is an effective way to increase your supply as well.

Keep track & increase supply

Massage your breasts before and during your pumping session to maximize your output and improve the flow of your milk. Keep track of your pumping sessions with a log or notebook. This will help you remember how often you pump and how much milk you express. New moms get very tired – a log will help you remember when you last pumped. If you have questions or concerns, speak with your consultant and discuss your pumping log.

Where’s my milk?

After you give birth, you will start to see drops of colostrum, which is incredibly beneficial for your baby. In the beginning you may find it is easier to express your colostrum by hand into a spoon to feed directly to your baby. If you pump, these drops may get stuck in your breast pump parts. Have your consultant show you the best technique. Keep in mind, if you pump, you may not see any milk during your first few pumping sessions – do not be discouraged. Keep at it and ask your consultant for help and support.

Remember to avoid smoking, caffeine and alcohol. Speak with your health care provider about any medications you may be taking to be sure they are safe to take while breastfeeding.

Bottom line:

Stay positive. A pump can’t replace a warm baby at your breast, but any breast milk you supply your baby will help him get stronger and healthier each day. And soon he will be out of the NICU and in your arms!

Is donor milk right for your preemie?

Monday, November 23rd, 2015

feeding in the NICUFor premature babies, breast milk can be lifesaving. It is more easily digested and provides protection against many diseases. Providing breast milk, however, can be a challenge for some moms. Many moms are not able to provide their baby with their own breast milk for various reasons, they:

  • are recovering from surgery or have certain medical conditions that make it difficult to initiate and maintain a milk supply;
  • find it difficult to pump enough milk to meet their baby’s needs;
  • have chronic conditions and need to take medications that may make their breast milk unsafe.

In these cases, donor milk may be the best option for your preemie, and a better alternative to formula.

What is donor milk and where does it come from?

A milk bank is a service that collects, screens, processes and distributes safe human milk to babies in need. All donated milk goes through a pasteurization process to eliminate bacteria while keeping the milk’s essential nutrients. The milk is then packaged, stored and ready to ship to hospitals or individual recipients at home. Lactating women who wish to donate their breast milk may do so through a milk bank.

Does your preemie need donor milk?

The nutritional needs of each baby depends on many different factors. It’s important to talk to your baby’s doctor to see if donor milk is right for your baby. Some hospitals have their own donor milk bank or have a partnership with a milk bank near them. If your baby’s doctor indicates that your baby will benefit from donor milk, he can write a prescription. For more information about the milk bank closest to you, visit the Human Milk Banking Association of North America.

Can you buy breast milk from another mom who has milk to spare?

There are risks with getting breast milk from a stranger or a friend; this milk is not tested or screened for infectious diseases or contamination. A study published in the American Academy of Pediatrics showed that out of 101 samples of milk purchased online from different mothers, 74% of samples were contaminated with bacteria and 21% of samples contained cytomegalovirus (CMV) bacteria.

It’s important to be informed when making feeding decisions for your preemie. If you have any questions about donor milk or your baby’s nutritional needs, speak with your baby’s healthcare provider.

Skin to skin contact helps your baby AND you

Wednesday, November 11th, 2015

Skin to SkinResearch has shown that skin to skin holding, also known as “kangaroo care,” is one way to help stabilize your baby’s body temperature and help his heart rate become regular. It is comforting to your baby, and may help him gain weight. Even very sick or fragile babies can usually benefit from kangaroo care.

It’s good for parents, too. It helps you bond with your baby, which boosts your spirits. For moms, it encourages your breast milk supply, too.

What is skin to skin holding or kangaroo care?

It is when you hold your baby, skin to skin, bare chest to bare chest, in an upright position. Your baby is wearing only a diaper.

Does it have other benefits?

Yes. For your baby…

Skin to skin holding may help lower the risk of infection, improve survival rates, and encourage your baby to spend more time in deep sleep (which is important for growth and good health). It may also lessen your baby’s pain and help with brain development. Kangaroo care may help your baby spend more time being quiet when awake, and less time crying.

For you and dad…

Skin to skin increases the feeling of intimacy between the baby and parent, helping the mom or dad feel connected. Often dads are fearful of holding their baby – skin to skin may promote a sense of empowerment and confidence. It may decrease anxiety, fear and depression and encourages attachment. Parents say it is the most comforting activity they experience in the NICU.

One mom told us she wrote in her journal “Today I feel like a mother for the first time” – that was the first time she held her twin boys skin to skin, 5 weeks after they were born!

Should you ask to hold your baby?

Yes! If you have not yet held your baby skin to skin, ask if you can. Often, the NICU staff is just so busy with other important duties that they don’t think to offer it. Typically, your baby must be medically stable before he is ready for kangaroo care. But, you can do it even if your baby is hooked up to machines.

How much kangaroo care should you do?

The more you can do, the better. It has been shown that skin to skin contact should take place for a minimum of one hour, but several hours at a time are better. It takes a while for a baby to transition from the isolette to chest and back, so you must take that into account. In some countries, parents are encouraged to do kangaroo care round the clock – that’s how good it is for babies!

Still wondering if skin to skin holding is for you?

Watch this video.

Did you experience kangaroo care in the NICU? Please tell us about it.

 

Have questions? Email or text AskUs@marchofdimes.org. We are here to help.

Physical therapy – can it help your preemie?

Wednesday, October 14th, 2015

Preemie walkingMany children born prematurely may need help catching up with developmental milestones such as sitting, crawling or walking. They may need assistance learning everyday activities such as dressing, too. Physical therapy – one type of habilitative service – may help. Habilitative services are those therapies that help a child develop new skills needed for everyday life.

October is National Physical Therapy Month. This is a great time to become aware of the benefits that physical therapy (PT) can offer your child, whether he was born prematurely or full term.

What does PT do?

Physical therapy can help your child increase strength and flexibility. It can also improve posture, balance, coordination and movement. PT usually focuses on large muscle groups, such as the legs, but it can also involve the entire body.

A physical therapist is a professional who has specific training in understanding the way a body works – especially muscle groups. She can assess your child and provide individualized therapy which will help him improve in the areas where he is weak. PTs are very creative in their approach to working with children. In fact, the therapy can be lots of fun, and most children look forward to their PT sessions.

Does insurance cover PT?

Under the Affordable Care Act (ACA), habilitative services must be covered by insurance. They are included in the ACA as Essential Health Benefits, which means they need to be covered under individual and small group health insurance plans. Check your state for specific details. For information on enrolling in your state’s marketplace for health insurance, go to HealthCare.gov or call 1-800-318-2596.

Early intervention may include PT at no cost to parents

If your child is under the age of three, he may be eligible for Early Intervention services, which is a federal program provided in every state. Physical therapy is one of many services available for eligible infants and toddlers if they qualify. Therapy is usually provided at no cost to parents.

If your child is age three or older, he may qualify for PT through your local school district as a Related Service. This post will tell you how to access it.

Bottom line

As with all delays or disabilities, it is important to seek help as early as possible. The sooner your child gets the help he needs, the sooner he can begin improving.

Have questions? Text or email AskUs@marchofdimes.org.

See other posts on Delays and Disabilities: how to help your child.

 

Birth announcements for your preemie

Monday, June 1st, 2015

birth announcementThe birth of your baby is such an important and joyous time in your life. Many moms want to commemorate the birth by sending out birth announcements to friends and family. I remember when my nephew was born, my sister-in-law put together a small photo shoot in her living room in order to have the perfect picture to include on the birth announcement. Many parents, however, don’t anticipate giving birth early and having a baby in the NICU. If your baby was born weeks or even months ahead of schedule, how should you announce your baby’s birth?

As your baby is being cared for in the NICU, you may feel like you are riding an emotional rollercoaster. You don’t have to send out birth announcements right away. Your first priority is taking care of your baby (and yourself). Birth announcements are typically mailed out anywhere from a few days to a few months after the arrival of your little one, so wait until your baby’s health stabilizes and you feel ready to focus on it.

What if your baby was born weighing 3 pounds, or less – should you include the weight on the announcement?

This is totally up to you. If you feel uncomfortable sharing that information on a birth announcement, you don’t need to include it. Many parents of full-term babies often leave their baby’s weight off the announcement. You can include your baby’s name and date of arrival, which are the details family and friends really want to know.

Your baby’s birth may not have gone as planned, but as your rollercoaster ride starts to slow, you will want to give your child the welcome celebration that she deserves.

Passing the time while your baby is in the NICU

Friday, February 13th, 2015

Passing the time while your baby is in the NICUIt may be difficult to know what to do with your time when your baby is in the NICU. Going home to an empty house may seem impossible. All you can think about is how your little one is doing. However, there are all kinds of productive things you can do, to pass the time until your baby is ready to come home.

While at the hospital

• Learn about your baby’s condition as well as what to expect on the NICU journey.
• Get to know your baby. As soon as your baby’s condition allows, take an active role in his care. Feed, hold, bathe, diaper and dress your baby. Learn about preemie cues to help you understand your baby’s behaviors.
• Room-in with your baby. Some hospitals (depending on your baby’s condition) will allow you to spend the night caring for baby. Ask your nurse if this is an option.
• Read to your baby
• Learn how to take care of your other children while your baby is in the NICU. See if they can visit your baby in the NICU.
• Is a holiday coming up? Read our blog on spending the holidays in the NICU for tips.

While at home

• Get the right car seat for your child.
• Prepare your home for your preemie.
• Make sure you have food in the house or ask a friend or relative to get some groceries for you. Eating healthy foods will help you maintain your energy.
• Keep up with your chores; ask a relative or friend to help if you need it.
• Visit our website for information on managing the NICU experience.

Relax and rejuvenate

• Put your feet up. You need to take care of yourself in order to be able to take care of your baby.
• Take a nap: Getting enough rest is important during this time.
• Be active.  A short 10 minute walk once or twice a day will be more beneficial to you than you can imagine. If you can manage a longer walk, go for it. Or, join a class (like Zumba) where you can dance off your frustrations as you have fun.
• Take a yoga, meditation or a stretch and tone class or use a DVD. You can take them out of a library for free. These classes combine getting in shape with learning to calm down. Believe it or not, most people need to learn how to relax.

While at home or by your baby’s side, seek support by visiting Share Your Story®, the March of Dimes online community for NICU families. You will be welcomed and comforted by other NICU moms who are or have been in your situation and know how you are feeling.

Do you have a baby in the NICU? Email us at Askus@marchofdimes.org with your questions. We are here to help.

Preparing your home for your preemie

Tuesday, January 20th, 2015

Preemie going homeWe often receive questions about “preemie-proofing” from parents who are preparing for their preemie’s homecoming. You may have waited a long time for this day, but bringing your baby home, and leaving his team of doctors and nurses behind can be overwhelming for many parents. Here are some tips to help ease the transition:

Before your baby comes home:

• Speak with the NICU staff at your baby’s hospital. They are very knowledgeable about what your baby may need when going home.

• If you clean your home before your baby’s arrival, (or if you want to brighten up your preemie’s nursery by painting it) do so before he comes home. This way you can avoid any strong smells that may linger.

• Clean your house of dust and germs. Vacuum and dust often, take out the garbage and keep your kitchen and bathroom clean. Also, tell your baby’s health care provider if you have any pets. Pet hair can track in dirt and dust.

• If your baby needs oxygen, carefully observe the cleaning requirements, particularly for the humidifier, and understand the safety recommendations.

Once your baby is home:

• Your baby should not be exposed to smoke, aerosol sprays or paint fumes. These irritants can cause wheezing, coughing, and difficulty breathing.

• Maintain a smoke-free household. Post signs around your house if you need to so family and friends are aware of your smoke-free home.

• The guidelines for cleaning and storing bottles, nipples, pacifiers, breast pump equipment and milk or formula are the same for preemies as term babies.

• If your baby is on an apnea monitor, be sure you can hear the alarm from every room in your house.

• Wash hands after blowing your nose, diapering your baby or handling raw food. Don’t let adults or children who are sick, have a fever or who may have been exposed to illness, near your baby.

Visit our website here for more great resources for parents after they bring their baby home from the NICU.

What do you remember being helpful when you brought your preemie home? What tips would you recommend to new parents?

Staying positive in the NICU

Wednesday, November 12th, 2014

Passing the time while your baby is in the NICUHaving a baby in the NICU is stressful. Very stressful. When a baby is born prematurely, the roller coaster ride of the NICU experience is emotionally, physically and mentally taxing for parents.

Premature birth is the birth of a baby before 37 weeks of pregnancy. One in 10 babies is born prematurely, or 15 million babies globally! Of these babies, one million will die. Babies who survive often have lifelong health problems such as cerebral palsy, vision and hearing loss, intellectual disabilities and learning problems. Just knowing these statistics provokes anxiety and worry in parents. If you are a parent with a baby in the NICU, observing the ups and downs of your baby’s progress day to day can be heart wrenching and particularly wearing.

Depression more common in the NICU

Studies have shown that “in the month after delivery, parents of preemies are significantly more depressed and anxious than parents of term babies,” according to Linden, Paroli and Doron MD in the book Preemies – The Essential Guide for Parents of Premature Babies, 2nd Edition. The authors report that “Besides depression and anxiety, they (parents) were more apt to feel hostile, guilty, and incompetent at parenting and to isolate themselves socially…An early delivery is itself so scary that even many parents of healthy preemies react with shock and anxiety.” Given the stress associated with seeing your baby in the hospital, and the ups and downs of slow progress – it is not hard to imagine that depression is seen more often in parents of preemies than in parents of children born at term.

Baby blues and postpartum depression

Many new mothers experience the “postpartum blues” or the “baby blues.” Baby blues are feelings of sadness you may have three to five days after having a baby. These feelings most likely are caused by all the hormones in your body right after pregnancy. You may feel sad or cranky, and you may cry a lot. By about 10 days after the baby’s birth, the baby blues should go away. If they don’t, tell your health care provider who will determine if you may have postpartum depression (PPD), which lasts longer and is more serious than baby blues.

Signs of PPD include feeling tired all the time, having no interest in your usual activities, gaining or losing weight, changing your eating habits, having trouble sleeping or concentrating, and thinking about suicide or death. If you have five or more of these signs and they last for two weeks or longer, you may have PPD. Sometimes mothers of preemies develop postpartum depression as a result of the severe stress and anxiety experienced by having a premature baby. Even fathers of preemies can become depressed.

What can help?

There are many ways to feel better. Treatments for depression may include all or some of the following: healthy eating, regular sleep and exercise, talking with friends, family or a professional counselor/therapist, lowering your stress by taking time to relax and avoiding alcohol. In addition, your health care provider may give you medication specifically designed to help with depression.

Talking to other parents who have gone through the NICU journey can be very helpful. The parents on the March of Dimes’ online community, Share Your Story, “talk” to one another and share their experiences. It is a comforting and supportive community, where all NICU families are welcomed.

When will you feel better?

The length of time a parent feels down, anxious or depressed can vary, and may depend on the health of your baby, and the length of NICU stay. But usually, parents of preemies begin to feel more balanced as their baby grows, and “by the end of the baby’s first year, their psychological distress, on average, has been found to be similar to those of mothers of term babies” according to the Preemies book. But, each baby and NICU stay is unique, so each parent’s journey to feeling better is unique.

Bottom line

Having a baby in the NICU is extraordinarily stressful and difficult. You need to take care of yourself in order to be able to take care of your baby. It is important to be aware of the signs or symptoms of depression and to speak with your health care provider if you have any concerns at all.

The sooner you seek help, the sooner you will feel better.

 

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need, select “Help for your child” on the menu on the right side to view all of the blog posts to date. You can also view the Table of Contents of prior posts.

Feel free to ask questions. Send them to AskUs@marchofdimes.org.

Updated October 2015.